Hi, I'm something of a zombie on Bisoprolol 2.5mg daily for 2 years now. I have episodes of AF about every 2 weeks sorted with a second dose or a Valsava manoeuvre on one occasion.
How straightforward is it to change to a different anti AF drug?
All advice greatfully received please. (On both persuading the doc and the nitty gritty of changing the drug.)
H
Sorry folks. I've just discovered the very informative posts on this on the forum.
Didn't want to duplicate anything.
H
Private appointment with a cardiologist to discuss Flecainide (and other similar) to sort out the rhythm/stop AF with or without Biso to sort out the rate with the overriding proviso that QOL has to improve.
Was put on Bisopropol when first diagnosed but it didn't agree with me and was switched to Atenolol, been on it ever since, even after ablation. Doctors seem quite sniffy about it, their preference is Bisopropol, the new man in town, Atenolol is history. I remember my old dad being on it before he died years ago. Still, I think it's worked OK for me.
I was taken off half that dose of Bisoprolol after just three days as it brought my heart rate down too low so as you are taking twice as much, which is what the doc at my surgery had wanted before I told her that I was very sensitive to drugs! Flecainide, originally prescribed by a private EP, as a PiP after nothing else was suggested at the surgery, has virtually put an end to episodes for me now that I take it regularly and I have even been able to reduce the first dose of the day to 50mg, retaining 100mg for the evening. It might suit you too.
hi, Bisoprolol is the cheap med, you need to be on Nebivalol it’s more cardio selective than Bisoprolol you will feel lots better or at least I did
I agree with Prince123456 biooprolol did not agree with me and felt instantly better when switched to nebivalol.
Another one here feeling much better on Nebivolol, I started on 1.25 but have increased to 2.50. I definitely don’t feel so drained of energy. It has taken my resting heart rate down to 55 though, I might go back to 1.25, I’ll ask the doctor next time I see her.
Hi
Wondering what your BP is and H/Rate is before you think about changing.
Bisoprolol should control your BP and a little H/Rate.
Flec.... will only try and will try and get your irregular rhythm regular. It wll not control or try to control your H/Rate and BP.
If your BP is lower than 130 / 70 I would reduce that 1st down to 1/2 x2.5mg at night.= 1.25.
If your H/Rate is under 80 in comparison with above, take 1.25mg.
BB betablockers did not control my rapid H/Rate enough. Day 156, Night 47avg. So a private Cardiologist introduced me to CCB Diltiazem 180mg CD.
Although 1/2 dose this dose was reduced to 120mg CD.
With combination of BB and CCB H/Rate 60s day and my usual 47avg bpm Night.
In December BP were low 108/60s so dropped off Bisoprolol.
Now 133/80. and 80 H/Rate.
I feel you are not being guided appropriately. Usually you are on Bisoprolol for control of BP and/or H/Rate. Usually you would be trialled on separately a BB and CCB (which has a safe anti-arrhymic action to it).
Just an alternative solution to your Bisoprolol which is an excellent med for AFers. By folks reducing the dose 1.25 or some 1/2 it again it still does it's role.
I did notice some reduction in fatigue especially my afternoon sleep is not needed. Nut AF itself can tire you.
cheri JOY. 76. (NZ)
Hi Joy. Thank you for your reply. Typical resting BP is 115/70, pulse around 60.
Hi
So you may be fatigued because slightly low on BP but exceptionally low pulse Day.
I would trial slowly 1/2 x 2.5mg = 1.25mg then ECG that.
Be patient Hollins until you are settled. Even ask for a 24hr Heart Monitor which is the best truth of how your meds are working.
I can't have Flec, cardioversion or an ablation. It is a risky med so it is normal to have an ECHO which is read by your cardiologist. I have heart structural damage.
Caused by 2 years 3 months of this side of my Embollic Stroke, Rapid & Persistent AF and Thyroid Cancer (which caused the AF and the clot to my left frontal lobe).
AF can be caused by many different situations.
My cardiologist states 80 as the optimum resting rate Day.
cheri JOY. (You are attentive!)
Those rates should give you scope at least to reduce to 1.25mg Biso. You don’t say how long it takes you to convert to NSR when you experience an episode or what your heart rate is when AF occurs, but an option may be taking Biso as a PIP to limit the heart rate during an episode if it’s longer lasting. Depends what shape your heart is in (I take it you’ve had an echo to check heart function?) My own episodes of PAF are both infrequent and very short, so I prefer to put up with the racing heart rather than take a betablocker. You’ll find quite a lot of commentary elsewhere on this forum about the pros and cons of Biso.
Hi Drone01
Thanks for your reply. It's made me review what's been happening.
I had a normal echo 2 years ago.
The AF episodes usually kick in about every 2 weeks. Typically afternoon or evening. I'll be sitting, sometimes eating sometimes not. No specific food sometimes alcohol, sometimes not. Don't do much tea or coffee. No idea what my heart rate is when AF starts up. Never had a 24hr ECG (or BP).
I take 2.5mg bisoprolol daily at night. When AF starts up I take a further 2.5 and after 2-3 hours if I'm still in AF I take another 2.5. So in a 2 day period I've taken 3 tablets. I seem to go back into sinus rhythm around bedtime or wake in the night back in SR.
H
I’ve been n Flecainide for 5 years now, it’s kept me in NSR the entire time. I feel great, work out at my gym 4 days a week, hike frequently, and live a normal life again. When I first started taking it, I might have felt a little less energetic, but soon I did not notice any difference at all. Can’t say enough about it I’m thankful it exists?
I went from Bisoprolol and Digoxin combination to just Sotalol as advised by my cardiologist. No dithering about, just started it the next day. No after effects, indeed, it stopped my atac after 24 hours.
As I understand anti arrhythmic medications are very powerful reacting on the central nervous system. I was on a couple of different ones but Flecinide the longest. I didn’t know how bad they made me feel until I went off of them. It was like having my life back. Perhaps there are people who have no side effects. Good luck.
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